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HomeMy WebLinkAbout1000-9.-8-3.2 OVVICE LOCATION: Town I-Iall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD ']'o~ MEMORANDUM Leslie Weisman, Chair Members of the Zoning Board of Appeals From: Mark Terry, Principal Planner LWRP Coordinator Date: August 24, 2011 Re: Coastal Consistency Review for ZBA File Ref. HIRAM F. MOODY III #6497 SCTM#1000-9-8-3.2 Request for Vadance from Art. XXIll, Code Section 280-124 and the Building Inspector's June 30, 2011 Notice of Disapproval based on an application for building permit for an addition to a single family dwelling at; 1 ) less than the code required front yard setback of 35 feet, located at: Reservoir Road (VVinthrop Drive) (adj. to Silver Eel Cove) Fishers Island, NY. SCTM#1000-9-8-3.2 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney Office Location: Town Annex/First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 USPS Mailing Address.~ 53095 Main Road EO. Box 1179 Southold. NY 11971-0959 http://southoldtown.north fork.net BOARD OF APPEALS TOWN OF SOUTHOLD July 14, 2011 Mark Terry, Principal Planner LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold, NY 11971 Re: ZBA File Ref. No. # 6497 MOODY, H. & G. 1000-9.-8-3.2 Dear Mark: We have received an application for additions to a single family dwelling. A copy of the Building Inspector's Notice of Disapproval under Chapter 280 (Zoning Code), and survey map, project description form, are attached for your reference. Your written evaluation with recommendations for this proposal, as required under the Code procedures of LWRP Section 268-5D is requested within 30 days of receipt of this letter. Thank you. Encls. Very truly yours, Leslie~ ?dsm/an //';. /~ C ha~,d¢~ n FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT NOTICE OF DISAPPROVAL DATE: June 30, 2011 TO: Steve Harem for H & G Moody 38 Nugent St. Southampton, NY 11968 Please take notice that your application dated June 17, 2011 For a permit for an addition to a single family dwelling at Location of property: Reservoir Rd., Fishers Is., NY County Tax Map No. 1000 - Section 9 Block 8 Lot 3.2 Is returned herewith and disapproved on the following grounds: The construction of an addition on a non-conforming 15,151 sq. ff. parcel, is not permitted pursuant to Article XXlll Section 280-124 which states: "This section is intended to provide minimum standards for granting of a building permit for the principal buildings of lots which are recognized by the town under 280-9, are nonconforming and have not merged pursuant to 280-10." Lots measuring less than 20,000 shall have a minimum front yard setback of 35 feet. The survey indicates a proposed front yard setback of 28'. Authorized Signature TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork. net Examined ,20 Approved ,20 Disapproved a/c Expiration ,20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mailto: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date June 16 ,20 11 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within I2 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) Stephen L. Ham, III 38 Nugent Street, Southampton, NY 11968 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder agent for co-owners Hiram F. Moody, Jr. and Sarah R. Goulard Nameofownerofpremises Hiram F. Moody, Jr. and Sarah R. Goulard (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. n/a Plumbers License No. n/a Electricians License No. n/a Other Trade's License No. n/a 1. Location of land on which proposed work will be done: i28 Reservoir Road Fishers Island House Number Street County Tax Map No~ 1000 Section 0,09..00 Subdivision n/a Hamlet Block 08.00 Filed Map No. n/a Lot 003.002 Lot n/a 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy_ single-family dwelling w'lth open deck b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost to be determined 5. If dwelling, number of dwelling units one If garage, number of cars n/a single-family dwelling with addition of living space over Addition Other Work Fee $50.00 former deck x Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. n/a 7. Dimensions of existing structures, if any: Front SEE MAP Height c. 25' Number of Stories z Rear SEE MAP Depth SEE MAP Dimensions of same structure with alterations or additions: Front SEE MAP Rear SEE MAP Depth SEE Y~ Height. same Number of Stories same 8. Dimensions of entire new construction: Front SEE MA1> Rear SEE MAP Height c. 11' Number of Stories one .Depth SEE MAP 9. Size of lot: Front SEE MAP 10. Date of Purchase 05/09/11 Rear SEE MAP Depth SEE MAP Name ofFormer Owner Hiram F. Moody, III 11. Zone or use district in which premises are situated R-40 12. Does proposed construction violate any zoning law, ordinance or regulation? YES x NO__ 13. Will lot be re-graded? YES NO x Will excess fill be rerooved from premises? YES -- c/o SL Ham 38 NBgent St. 14. Names of Owner of premises HF Moody, Jr. Address Southampton, NY PhoneNo. Name of Architect Jacob Albert Address 8 Winter St. Bos~Phone No Name of Contractor unknown Address ton, MA 02018 PhoneNo. NO x (631) 283-2400 (617) 451-5740 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES x * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES x NO * IF YES, D.E.C. pE~IT, S .MAy BE REQUIRED. NO 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES · IF YES, PROVIDE A COPY. NO x STATE OF NEW YORK) SS: COUNTY OF SUFFOLI9 Stephen L. Ham, III being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the authorized agent (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 16th day of June 20 11 ~ Notary Pub~"~ Signature of Applicant Stephen L. Ham, III HAY HARBOR APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS Uouse No. 128 Street RESERVOIR ROAD Hamlet FISHERS ISLAND SCTM 1000 Section 009 Block 08 Lot(s) 003.002 Lot Size .35 ACRE Zone R-40 l (WE) APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED JUNE 30. 2011 BASED ON SURVEY/SITE PLAN DATED JUNE 7. 2011 HIRAM F. MOODY, JR. and SARAH R. GOULARD Applicant(s)/Owner(s): Mailing Address: P.O. BOX 2119, WICKENBURG, AZ 85358 Telephone: (631) 283-2400 Fax: (631)287-1076 Emaih matthamesq@aol.com NOTE: In addition to the above~ please complete below if application is signed by applicant's attorney, agent, architect, builder, contract vendee, etc. and name of person who agent represents: STEPHEN k. HAM, III, ESQ..forr~wne~Dther: Name of Representative: c/o MATTHEWS & HAM, 38 NUGENT STREET, SOUTHAMPTON, NY 11968 Address: Telephone: (631) 283-2400 Fax: (631) 287-1076 Email: matthamesq@aol.com Please check to specify who you. A~d.~t correspondence to be mailed to, frqlll.~e above names: I I~Applica nt/Owne r(s),~1~'1A utho rized Rep resentative, U Other Nam e/Add tess below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED ~UNE ?, 20~1 and DENIED AN APPLICATION DATED JUNE ~6, Building Permit Certificate of Occupancy ( ) Pre-Certificate of Occupancy Change of Use Permit for As-Built Construction Other: FOR: Provision of the Zoning Ordinance Appealed. (Indicate Article, Section, Subsection of Zoning Ordinance by numbers. Do not quote the code.) Article: xx~: Section: 280-~24 Subsection: Type of Appeal. An Appeal is made for: FT]A Variance to the Zoning Code or Zoning Map. [ A Variance due to lack of access required by New York Town Law- Section 280-A. Interpretation of the Town Code, Article Section [~Reversal or Other A prior appeal [] has, [~ ] has not been made at any time with respect to this property, UNDER Appeal No(s). o? 700 Year(s). t/qt~) . (P/ease be sllre to research before completing this qlte ~tiorl or call our off,cellar assi~tanr e) Moody and Goulard ZBA l,'i]e # I'~ F. AS () N S FO 1~..\ P PEA 1~ (,ddilion l:l ',heels m, V be u.~ed w/lh FrcFarer's .~i~,nanu'e): .IRI:' I I .IRLI'~UA' RE, ISONS: (1) An undesirable change will not be produced in tile CllAI~.ACTIi;R of lhe ncigl;borhood or a detriment ~o nearb~ properties il'~ranted, because: Use of additional living space is a permitted use. Owners are simply enclosin~ an area where there is already an existing deck. Removal of that deck and steps will actually result in a reduction of lot coverage from 11% to 10.5 %. (2) The benefit sought by lite applicant CANNOT be achieved by some method feasible fi~r the The size an0 configuration of the lot an~ its location with frontage on two streets produce a severely constrained permitted buildin~ envelope. (3) The amount of relief requested is noir subs[antial because: The addition will merely replace an existing structure (deck with steps) and its setback from the street line will actually be greater than what now is present for that structure. The new addition will meet 80% of required minimum. (4) The vat'iance will NOT have an adverse cf feel (ir imlmel on Ihe physical or envirotmlenlal conditions in lhe neighborhood or district hccause: The area of the proposed construction has already been disturbed as it is currently improved with a deck and steps that will be removed. Using that area will therefore have a lesser impact than placing addition on other side of the dwelling in a conforming location. (5) llas the alleged difficulty been sclf-crealcd? E~]Ycs, or [~])No. Are there Covena.ls and l.~estrictions concerning this land: [] No. [~Yes (i,lea~e [itrni~h cvpV). This is the MINI,MUM that is necessary and adequate, and at lhe same time preserve and prolec! the character of the neighborhood and Tile hcallh, salYty, and wclfiwe of the comnumity. ('hi,ok thL~ box ~ Ih' 4 l/Sl: I(~IRIANCE IS BEING REQUESTED, AND PI. AMSE UOM?LETIf TI[I: .4 T771£'IIIf D USE I ; IRI, h¥CIi SIII~Ii'I? (Ph'a~{' he ~lll't· to con.sltll )'ottr atto~lt'~x) v. Signature of Appelhmt or Au0mrized Agent S;~ ertl lo Iici'ore mc Ibis '~ ~ day of July ,2111 1 . Notary Public BARBARA T. HAM NOtal¥ .Public, State of New York NO 0~1~9 ~allfled In Suffolk County ~mission ~pire8 August 1~, ~ Stephen L. Ham, III APPLICANT'S PROJECT DESCRIPTION (For ZBA Rel~rence) Applicant:HIRAM F. MOODY, JR. 8, SARAH IR. GOULARD Date Prepared: ,JULY '7, 20'1 '1 I. For Demolition of Existing Building Areas Please describe areas being removed: APPROXIMATELY 370 SQUARE FEET OF DECK AND STEPS Il. New Construction Areas (New Dwelling or New Additions/Extensions): Dimensions of first floor extension: 9.5 FEET X 32.0 FEET Dimensions of new second floor: N/A Dimensions of floor above second level: N/A Height (from finished ground to top of ridge): 12 FEET Is basement or lowest floor area being constructed? If yes, please provide height (above ground) measured from natural existing grade to first floor: N/A 111. Proposed Construction Description (Alterations or Structural Changes) (attach extra sheet if necessary) - Please describe building areas: Number of Floors and General Characteristics BEFORE Alterations: 2 FLOORS WITH EXTERIOR DECK Number of Floors and Changes WITH Alterations: 2 FLOORS WITH NEW INTERIOR ROOM REPLACING EXTERIOR DECK IV. Calculations of building areas and lot coverage (from surveyor): Existing square footage of buildings on your property: C. 2,075 SQUARE FEET Proposed increase of building coverage: DECREASE OF ABOUT 75 SQUARE FEET Square footage of your lot: 15,151 SQUARE FEET Percentage of coverage of your lot by building area: EXISTING: 11% PROPOSED: t05% V. Purpose of New Construction: CREATION OF ADDITIONAL LIVING SPACE VI. Please describe the land contours (flat, slope %, heavily wooded, marsh area, etc.) on your land and how it relates to the difficulty in meeting the code requirement(s): LAND IS SLOPED BUT CONTOURS ARE NOT APPLICABLE TO DIFFICULTY IN MEETING CODE REQUIREMENTS Please submit seven (7) photos, labeled to show different angles of yard areas after staking corners for new construction), and photos of building area to be altered with yard view. 7/2002; 2/2005; 1/2007 QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION Is the subject premises listed on the real estate market for sale? Yes x No Are there any proposals to change or alter land contours? x No Yes please explain on attached sheet. I.) Are there areas that contain sand or wetland grasses? yes 2.) Are those areas shown on the survey submitted with this application? yes 3.) Is the property balk headed between the wetlands area and the upland building area? no 4.) lfyour property contains wetlands or pond areas, have you contacted the Office of the Town trustees for its determination ofjurisdiction?pend±ng_Please confirm status of your inquiry or application with the Trustees: and if issued, please attach copies of permit with conditions and approved survey. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? no Are there any patios, concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting? no Please show area of the structures on a diagram if any exist. Or state none on the above line. Do you have any construction taking place at this time concerning your premises? no .If yes, please submit a copy of your building permit and survey as approved by the Building Department and please describe: Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If any are lacking, please apply to the Building Department to either obtain them or to obtain an Amended Notice of Disapproval. Do you or any co-owner also own other land adjoining or close to this parcel? no If yes, please label the proximity of your lands on your survey. Please list present use or operations conducted at this parcel single-family residence w/deck and theproposeduse same with addition of living space in place of: deck (to be removed) .(ex:existingsinglefamily, proposed: same with garage, pool or other) 07/07/11 Authorizedsign~ureand Dme Stephen L. Ham, III, authorized agent FORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No Z-25513 Date FEBRUARY 4, 1998 THIS CERTIFIES that the building Location of Property. RESERVOIR RD. House No. County Tax Map No. 1000 Section 9 Subdivision ONE FAMILY DWELLING FISHERS ISI2%N-D, Nqf Street Hamlet Block 8 Lot 3.2 Filed Map No. Lot No. conforms substantially to the Requirements for a One Family Dwelling built Prior to: Ai~RIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z-25513 dated FEBRUARY 4, 1998 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING * The certificate is issued to RICHARD C. GILBERT (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTActi~D INSPECTION REPORT. ///~3 u ±~/d~ n cj In~poctor Rev. l/S1 I,OC^TIOH: Rese~olr Road Fishers Island, N.Y. STE_PttE_~N L~__tI./~4~_3~_I.._.AT_T~ ..................... DA'rE: DEC. 0CCUI'ANC¥ RES IDENTI/LL (type) ADH t TTLrl) 11¥ t SELF RIt.¥ AVAI1.AIII.E · qOIIRCE OF RI~I]UEgT~ TYPL~ OF C'OH,UTIIUCTION FOIIHDATTON TOTAl, ROOH,q ." , II/VI'III~()OH (a) I~O[[CII TYI'E I)OHESTIC, IIO'I'~ATEll 'I'Y I'F~ IIgAT OIL WOOD FRAME POURED CONCP, gTE I ,~'r FI.lt. 2 I S'I'OR I Ir. fi 2 2/3 YES IIF. CK, T¥ I'F. WOOD ['AT1 0 It I IU~I'I .ACIt. TYPLr l1E fi'I'll. I~ TANKLE S fi Al IICOHI)ITI ()Ill Hi| ~ A IIi'l Alii 110'{'I4A Tit, R XX I Ir.X ACCIt. S~ORY fiTI~UCTUItE$: (,AItA(,L, 'l'YI'g OV CONST. !;~4 ItlH 1NG ['001. I)Tlllr, l[: WOOD FRAME VI()I,A'I'IOHB: CIIAPTEIt 45 N.Y. S'I'A'I'Ir. UNIFOliH VIllit, [,Itlt. Vl~,tl'l'lON & liUII.I)iHO COIW. l ,()C3 AT 1 OH I)I.~ SCl1. I ['T I ()Fl ART. CO Z-22295, BP l,~17998-Z- ........ Re Io 23-z O)ECE ........................... BP 1123090-Z (ACCESSORY) CO Z-25514 IHHI'I~C'II~I) IlY ROBERT W~L I}A'II~ I)lr INfiI'E(;TIi)~_ ~/_9_(~_~I_NS~EC~D 1/30/98 .... TIHI~ S'I ART E~I) ....................... FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25514 Date: 02/04/98 THIS CERTIFIES that the building ACCESSORY Location of Property: RESERVOIR RD. (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 9 Block 8 Subdivision Filed Map No. Lot No. FISHERS ISLAND (HAMLET) Lot 3.2 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 15, 1995 pursuant to which Building Permit No. 23090-Z dated OCTOBER 30, 1995 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this csrtificate is issued is ACCESSORY STORAGE SHED IN FRONT YARD AREA AS APPLIED FOR. The certificate is issued to RICHARD C GILBERT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A //U/ing Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTPtENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25515 Date: 02/04/98 THIS CERTIFIES that the building ALTERATION Location of Property: RESERVOIR ROAD FISHERS ISLAND (HOUSE NO.) (STREET) (~ET) County Tax Map NO. 473889 Section 9 Block 8 Lot 3.2 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 2, 1989 pursuant to which Building Permit No. 17998-Z dated APRIL 7, 1989 was issued, and conforms to all of the requirements of the applicable provision~ of the law. The occupancy for whLch this certificate is Lssued is ALTER CLOSET TO BATHROOM IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RICHARD C. GILBERT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. PENDING 01/30/98 PLUMBERS CERTIFICATION DATED 01/30/98 RICHARD C. GILBERT //u~ding ~nspector Rev. 1/81 Hiram F. Moody, Jr.,as Trustee Sarah R. Goulard, as Trustee 2127 Rabbit Road Wickenburg, AZ 85390 July 5, 2011 Board of Appeals Town of Southold 53095 Main Road Southold, NY 11971 Re: Application for Variance at Premises at 128 Reservoir Road, Fishers Island (SCTM No. 1000-009.00-08.00-003.002) Dear Board Members: The undersigned, Hiram F. Moody, Jr., in his capacity as Trustee of the Hiram F. Moody, Jr. QPRT u/d May 16, 2011, and Sarah R. Goulard, in her capacity as Trustee of the Sarah R. Goulard QPRT u/d May 16,2011, as co-owners of the referenced premises situate at Fishers Island, New York, hereby authorize Stephen L. Ham, 111 of Matthews & Ham, 38 Nugent Street, Southampton, New York 11968, to act as our agent in making such applications to your Board and in taking any and all incidental actions in regard thereto, including without limitation, completing and executing the required forms, giving any required notices and appearing at any public hearings, as he shall deem necessary or advisable in order to obtain approval of a variance or variances and such other relief as your Board may deem just and proper with respect to such premises in accordance with the Site Plan prepared for Hiram F. Moody, Jr. and Sarah R. Goulard, by CME Associates Engineering, Land Surveying & Architecture PLLC, dated June 7, 2011, as the same may be revised from time to time. Very truly yours, Hiram F. Moody, Jr., as Trustee Sarah R. Goulard, as Trustee APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER andOWNER'S AGENT) The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of Town officers and employees. The purpose of this form is to provide information, which can alert the Town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: HIRAM F. MOODY, JR. (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person or company name.) NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance Special Exception If "Other", name the activity: Change of Zone Approval of Plat I Exempt on from P at or Official Map I [ Other Do you personally, (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the Town officer or employee has even a partial ownership of (or employment by) a corporation in which the Town officer or employee owns mom than 5% of the shares. YEs [ ] NO Complete the balance of this form and date and sign be~6w where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself (the applicant) and the Town officer or employee. Either check the appropriate line A through D (below) and/or describe the relationship in the space provided. The Town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): [ I A) the owner of greater than 5% of the shams of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); ] C) an officer, director, partner, or employee of the applicant; or I D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this Signature: __ CZ21~ Print Name: HI~Y,-dN. APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER am/OWNER'S AGENT) The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of Town officers and employees. The purpose of this form is to provide information, which can alert the 'Fown of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: SARAH R. GOULARD (La.st name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company, lfso, indicate the other person or company name.) NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance Special Exception If "Other", name the activity: Change of Zone [ ] Approval of Plat Exempt on from P at or Official Map Other Do you personally, (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the Town officer or employee has even a partial ownership of (or employment by) a corporation in which the Town officer or employee owns more than 5% of the shares. YES [ ] NO I~------'--'1 Complete the balance of this form and date and sign below where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself (the applicant) and the Town officer or e~nployee. Either check the appropriate line A through D (below) and/or describe the relationship in the space provided. The Town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): [ IA) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); [ B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); ] C) an officer, director, partner, or employee of the applicant; or ] D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submittedt~_dayof~ ( ) Signature:~l~ ~ ~ Print fjOL i ~ , DOARO OF APPEAL~ Jacob D. Albe~ 262 ~asbi~gto~ St., ~d Floor Bosto~ ~A 0~108 ,JUL ~ ~,OARD OF APPEA~S REC, Ez~(LL~ JUL ! 4 Jacob D. Albert E~OARD OF APPEALS ARCHITECT 262 Washington St., 2nd Floor Boston MA 02108 617-451-5740 .? ~'~ ...... Jacob D. Albert ARCHITECT 262 Washington St., 2nd Floor Boston MA 02108 617-451-5740 ~ D Jacob D. Albert ARCHITECT 262 Washington St., 2nd Floor Boston MA 02108 617-451-5740 pROJECT I.D. NUMSER 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only .PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEQR 1. APPUCANT /SPONSOR Hiram F. Moody, Jr. & Sarah R. Goulard 2. PROJECT NAME Addition to Dwellin~ at 128 Reservoir Rd. pl~OJ EOT LOCATION: Town of Southold County Suffolk Muntclpallly PRECISE LOCATION (Street address and roaci In[ersect~ons. prominea! landmarks, etc., or provide mapt 128 Reservoir Road, Fishers Island, New York (SCTM No. 1000-009.00-08.00-003.002) removal of existing deck and steps on exterior of house and replacement of the same with an addition to be enclosed and used as living space 0.35 ultimately 0.35 acres the proposed addition is located partially outside the permitted building envelope which requires a 35-foot front yard setback; proposed addition is as close as 28' WHAT IS PRESENT LAND USE IN VICiNiTY OF PROJECT? [] Residential [] tndustrl&J [] Commercial [] Agriculture [] parPJFo~'msUOpen $~ace [] Order sescrme: R-40 Zone District under the Town of Southold Zoning Code Town of Southold Building Department for building permit if variance is granted Town of Southold Board of Trustees for permit or letter of non-iurisdiction I CE~'I?Y THAT THE..~NFO,RMATION PROVIDED ABOV~E IS TRUE TO THE BE~T OF MY KNOWLEDGE ~lram F. MOOdy, Jr. and Saran R. Goulard By Stephen L. Ham, III, authorized agent D,~,: 07/12/11 I! the action is in the Coastal Area, and you am a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART FI--ENVIRONMENTAL ASSESSMENT (To be completed by Agency) D WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? --' Yes [] NO II Yes, explain Prietly PART Ill--DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse eflect identified above, determine whether it LS substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urPan or rura0; (b) proPabillty of occurring; (c) duralion; (d) irreversibility; (e) geographic scope; and {f~ magnitude. If necessary, add attachments or reference supporting materials. Ensure thai explanations contain sufficient detail Io show that all relevant adverse impacts have Peen identified and adequately addressed. If question D of Part II was checked yes, [he determination and significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CF_A. [] Check this box if you have identified one or more potentially large or significant adverse ire'ti,acts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive demaration. [] Check this box if you have determined, based on the information and analysis above and &ny supporting documentation, that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary, the reasons supporting this determination: Dale AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: The form must be completed by the applicant for any special use permit, site plan approval, use variance, or subdivision approval on property within an agricultural district OR within 500feet of a farm operation located in agricultural district. All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Sections 239- m and239-n of the GeneraIMunicipal Law. l) Name ofApplicant: Stephen L. Ham, III, as authorized agent 2) AddressofApplicant: 38 Nugent Street, Southampton, NY 11968 3) Name of Land Owner (if other than applicant): H±ram F. Moody, Jr. & Sarah R. Goulard 4) Address ofLand Owner: 2127 Rabbit Road, W±ckenburg, AZ 85390 (PO Box 2119 - 85358) 5) Description o£Proposed Project: removal of existing ester±or deck and steps and construction of addition to dwelling (enclosed living space) in their place 6) Location of Property (road and tax map number): 128 Reservoir Road, Fishers Island SCTM No. 1000-009.00-08.00-003.002 7) ls the parcel within an agricultural district? [~No []Yes If yes, Agricultural District Number 8) Is this parcel actively farmed? {~No [Yes 9) Name and address of any owner(s) of land within the agricultural district containing active farm operation(s) located 500 feet of the boundary of the proposed project. (Information may be available through the Town Assessors Office, Town Hall location (765-1937) or from any public computer at the Town Hall locations by viewing the parcel numbers on the Town of Southold Real Property Tax System. Name and Address (Please use back side of page if more than six property owners are identified.) The lot numbers may be obtained, in advance, when requested from either the Office of the Planning Board at 765-1938 or the Zoning Board of Appeals at 765-1809. Signature of Applicant Date Stephen L. Ham, III, authorized agent Note: I. The local board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their lama operation. Solicitation will be made by supplying a cop3' of this statement. 2 Comments returned to the local board will be taken into consideration ~s part of the overall review of this application. 3 Copies of the completed Agricultural Data Statement shall be sent by applicant and/or the clerk of the board to thc property owners identified above The cost for mailing shall be paid by the applicant at the time the application is submitted for review Failure to pay at such time means the application is not complete and cannot be acted upon b.~ the board 1-14~09 APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER and OWNER'S AGENT) The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of Town officers and employees. The purpose of this form is to provide information, which can alert the Town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: MOODY, HIRAM F., JR. and GOULARD, SARAH R. (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person or company name.) NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance Special Exception If "Other", name the activity: Change of Zone [ Approval of Plat I Exemption from Plat or Official Map [ [ Other ~ I Do you personally, (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the Town officer or employee has even a partial ownership of (or employment by) a corporation in which the Town officer or employee owns more than 5% of the shares. YES[ [ NO I ,/ I Complete the balance of this form and date and sign below where indicated. Name of pets on employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself (the applicant) and the Town officer or employee. Either check the appropriate line A through D (below) and/or describe the relationship in the space provided. The Town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): 1~"---] A) 'the owner of greater than 5% of the shares of the corporate stock of the appIicant (when the applicant is a corporation); l B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); ] C) an officer, director, partner, or employee of the applicant; or ] D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this Signature: Print Name: STEPHEN L HAM~ Iii, AUTHORIZED AGENT Town of Southold LVCRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actiort¥ including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard,4rea. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the planmng Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 1000-009 .-00-08.00 - 003. 002 The Application has been submitted to (check appropriate response): TownBoard [] Planning Dept. [] Building Dept. [-~ BoardofTrustees [] Board of Appeals X Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital [] construction, planning activity, agency regulation, land transaction) [] (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: setback var±ance to Zoning Code to permit construct±on of an add±tion to an existing single-family dwelling Location of action: Site acreage: 128 Reservoir Road (corner of Reservoir Road and Winthrop Drive) Fishers Island 0.35 acre Present land use: residential property improved with single-family dwelling Present zoning classification: R-40 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Fl±ram F. Moody, Jr. and Sarah R. Goulard (b) Mailing address: P.o. Box 2119, Wickenburg, Arizona 85358 (c) Telephone number: AreaCode ( ) c/o Matthews & Ham (631) 283-2400 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] No ~] if yes, which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section llI- Policies; Page 2 for evaluation criteria. ~Yes [] No [] (Not Applicable- please explain) property is already essentially developed; addition to be placed in an area on the property that is already disturbed Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III -Policies Pages 3 through 6 for evaluation criteria [] Yes [] No [] (Not Applicable- please explain) project is a simple addition to an existing dwelling Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [~ Yes [] No [] (Not Applicable- please explain) project is not intended to nor will it have any impact on visual quality or scenic resources Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~ Yes [] No [] (Not Applicable- please explain) location of proposed add±tion on property is well outslde of flood areas Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria [] Yes [] No [] (Not Applicable- please explain) project is not designed or intended to have nor will it have any impact on water quality Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. [] Yes [~ No ~ (Not Applicable - please explain) project is neither designed nor intended to have nor will it have any impact on the quality or function of the Town of Southold ecosystems Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. See Section III - Policies Pages; 34 through 38 for evaluation criteria. [] Yes ~ No [] (Not Applicable- please explain) project is not designed nor intended to nor will it have any impact on air quality Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. --~ Yes [] No [K] (Not Applicable- please explain) project is not designed nor intended to nor will it have any impact on environmental degradation from solid waste or hazardous substances PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [~ Ves~ No [] (Not Applicable - please explain) project is located on private property to which the public does not now nor will it have a right of access or use Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. [~ Yes [] No [~ (Not Applicable - please explain) project is not designed or intended to nor will it have any impact on water-dependent uses Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. [] Yes [] No [~ Not Applicable - please explain project is not designed nor intneded to nor will it have any impact on living marine resources in Town waters or elsewhere Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. [] Yes ~-~ No [] Not Applicable- please explain no agricultural uses are now or will be undertaken at the property other than those ancillary to the single-family residential use Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ~'~ Yes [] No [-~ Not Applicable - please explain project is not intended to nor designed to nor will it have any impact on or affect the use and development of energy and mineral resources SUBMITTED BY: Stephen L. Ham, III, authorized agent July 7, 2011 Rpr 20 11 02:4~a HFMoodwZSRGoulard 631-788-5635 p. 1 Hiram F. Moody, Jr.,as Trustee Sarah R. Goulard, as Trustee 2127 Rabbit Road Wickenburg, AZ 85390 July 5, 2011 Board of Appeals Town of Southold 53095 Main Road Southold, NY 11971 Re: Application for Variance at Premises at 128 Reservoir Road, Fishers island t'SCYM No. 1000-009.00-08.00-003.002) Dear Board Members: The undersigned, Hiram F. Moody, Jr., in his capacity as Trustee of the Hiram F. Moody, Jr. QPRT u/d May 16. 2011, and Sarah R. Goulard, in her capacity as Trustee of the Sarah R. Goulard QPRT u/d May 16,2011, as co-owners of the referenced premises situate at Fishers island, New York, hereby authorize Stephen L. Ham, Ill of Matthews & Ham, 38 Nugent Street, Southampton, NewYork 11968, to act as our agent in making such applications to your Board and in taking any and all incidental actions in regard thereto, including without limitation, completing and executing the required forms, giving any required notices and appearing at any public hearings, as he shall deem necessary or advisable in order to obtain approval of a variance or variances and such other relief as your Board may deem just and proper with respect to such premises in accordance with the Site Plan prepared for Hiram F. Moody, Jr. and Sarah R. Gouiard, by CME Associates Engineering, Land Surveying & Architecture PLLC, dated June 7,2011, as the same may be revised from time to time. Very truly yours, Hiram F. Moody, Jr., as Trustee 1.) SURVEY MAP PROPERLY TO BE CONVEYEO TO HIRAM F, MOOOY. I, RESERVOIR ROAD FISHERS ISLAND, NY CHANDLER, PALMER ~ KING ARCHITECTURE~ ENGINEERING AND SURVEYING 110 BROADWAY NORWICH, CT G6360 DECEMBER 29, 1997 SCALE 1"-- 29 FT. 1.) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INOICATED HEREON. ANY EXTENSION OF THE USE SEYONO THE PURPOSE AGREED TO BE~gEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE ENGAGEMENT. 2.) IT iS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR~ TO ALTER AN ITEM IN ANy WAY. 3.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYOR'S SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF THE LANO SURVE'fOR. ,~,) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC SURVEY TRIANGULATION STATION "PROS". 5,) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX MAP 1000, SECTION 009~ BLOCK 8, LOT 3,002, 6,) TOTAL AREA = 1B,1B1~: SQ, FT, 7.) SiTE IS LOCATED IN R-40 ZONE. B.) EXISTING ~ OF LOT COVERAGE- 11~ PROPOSED ~{ OF LOT COVERAGE- 1G,5~ 9,) SASE FOR LEVELS- NGVD 1929 APPROX, UMITS TIDAL WETLANDS SILVER E~~L ~1 COVE DEED QUALI~f CONTROL CERTIFICATION 6 ET, HIGH STOCKADE ,. ;:°; F,E. NDE-- PROVIDE SILT ~NCE (s~ S 12'15'30"W 15,35' LINE LOCATION IRON ROD WOOD RAMP / / / / / / ROOF AREA-EXISTING &; PROPOSED = 1600 SF REQUIRED = 1600 SF X 1,0 X 2/12 = 267 CF 267 CF / 50.27 CF/VF = 5.5 VF USE ONE(l) - 8'~ X 6' DEEP DRY WELL, NOT TO SCALE OF ROAD X \ '\ \ APPROX. --SEWER LINE /~LRG~9 LOCATION SPIKE APPROX, LINE CONC. LOCATION EXISTING FLOOR EL.=26,9 WAL \ OIL FILL ¢FT. &~ VENT FENCE GARDEN POLE 195,00~ 237.00' o/w o/~ POLE CONC. WINTHRop r uAb) SQ. FT. LOCATION MaP SPIKE BUILDING SETBACK LINE NOW OR FORMERLY SQUARE FEET STONE RETAINING WALL OVERHEAD WIRES CHAINLINK FENCE WOOD FENCE SPOT ELEVATION JUL Z 4 2011 ~OARD OF APP;AE~ MAP __ :ViE ,BY ZBA SEE CFC, # 20 10 0 20 GRAPHIC SCALE IN FEET DATE: SCALE: SHEET: 06/07/2011 1" = 20' 10F1